Review Article

Male Osteoporosis in the Elderly

Table 1

Summary of treatment guidelines for male osteoporosis.

OrganizationPharmacological treatment recommendations

National Osteoporosis Foundation (NOF) [48](i) Age ≥ 50
(ii) Hip or vertebral fracture
(iii) -score less than −2.5 at femoral neck, total hip, or lumbar spine; -score between −1.0 and −2.5 at the femoral neck or lumbar spine
(iv) 10-year probability of a hip fracture >3% or a 10-year probability of a major fracture >20% based on the US-adapted FRAX

The Endocrine Society [51](i) Hip or vertebral fracture without major trauma; BMD of spine, femoral neck, or total hip 2.5 SD or more below mean of normal young males
(ii) -score between −1.0 and −2.5 at the femoral neck or lumbar spine plus a 10-year probability of a hip fracture >3% or a 10-year probability of a major fracture >20% based on FRAX
(iii) Age ≥ 50 and long-term glucocorticoid therapy (equivalent to 7.5 mg or greater of prednisone for 3 months)

Osteoporosis Canada [52](i) 10-year fracture risk >20% assessed with CAROC or Canadian FRAX
(ii) Prior hip or spine fracture, or multiple prior fractures
(iii) Moderate 10-year fracture risk (between 10% and 20%), if there are the following risk factors: vertebral fracture identified by imaging, previous wrist fracture in those over the age of 65 years or with -score less than or equal to −2.5, lumbar spine -score much smaller than femoral neck -score, androgen deprivation therapy for prostate cancer, long-term glucocorticoid use, recurrent falls, or other disorders associated with osteoporosis, bone, loss, or fractures

CAROC: Canadian Association of Radiologists and Osteoporosis.